Physicians should advise patients to stop taking PDE5 inhibitors, including VIAGRA, and seek
- Erectile dysfunction can be caused by various medical conditions; discuss treatment options with a doctor.
- The medication is generally well-tolerated but requires medical supervision.
- Side effects can include indigestion, muscle aches, or flushing.
- Avoid using sildenafil if you are pregnant or breastfeeding.
- Proper dosage and timing maximize the benefits of sildenafil 10mg.
prompt medical attention in the event of sudden decrease or loss of hearing.
What to avoid
Consistent with its known effects on the nitric oxide/cGMP pathway [see Clinical Pharmacology (12.1, 12.2)], VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated. After patients have taken VIAGRA, it is unknown when nitrates, if necessary, can be safely administered. Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point [see Dosage and Administration (2.3), Drug Interactions (7.1), and Clinical Pharmacology (12.2)]. VIAGRA is contraindicated in patients with a known hypersensitivity to sildenafil, as contained in VIAGRA and REVATIO, or any component sildenafil 50 mg india of the tablet. Hypersensitivity reactions have been reported, including rash and urticaria [see Adverse Reactions (6.1)].
Reduces progression of erectile dysfunction
There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Therefore, treatments for erectile dysfunction, including VIAGRA, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment. VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of 8.4/5.5 mmHg), [see Clinical Pharmacology (12.2)]. While this normally would be expected to be of little consequence in most patients, prior to prescribing VIAGRA, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity. These events, which may be accompanied by tinnitus and dizziness, have been
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 200mg | 360 + 10 Pills | 481.98€ 459.03€ | |
| Viagra Generic | 25mg | 60 + 4 Pills | 71.99€ 68.56€ | |
| Kamagra | 100mg | 180 + 6 Pills | 436.79€ 415.99€ | |
| Viagra Generic | 100mg | 120 + 6 Pills | 149.50€ 142.38€ | |
| Viagra Generic | 50mg | 30 + 4 Pills | 54.26€ 51.68€ | |
| Kamagra | 100mg | 32 Pills | 121.24€ 115.47€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Generic | 150mg | 10 Pills | 36.73€ 34.98€ | |
| Viagra Generic | 150mg | 270 + 10 Pills | 326.61€ 311.06€ | |
| Viagra Generic | 50mg | 60 + 4 Pills | 83.93€ 79.93€ | |
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Kamagra Oral Jelly | 100mg | 110 + 9 Sachets | 334.87€ 318.92€ | |
| Kamagra Polo | 100mg | 32 Pills | 125.88€ 119.89€ | |
| Kamagra Soft Tabs | 100mg | 120 + 6 Pills | 311.78€ 296.93€ | |
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ |
reported in temporal association to the intake of PDE5 inhibitors, including VIAGRA.
- Medication effectiveness can be impacted by certain health conditions.
- Men should not use sildenafil if they have a history of stroke.
- Sildenafil 10mg can sometimes cause nasal congestion.
- It’s important to report any unusual side effects to your doctor.
- Do not use sildenafil if you are taking other ED medications.
It is not possible to determine whether these events are related directly to
Which Makes You Harder?
Use with caution in patients with the following underlying conditions which can be particularly sensitive to the actions of vasodilators including VIAGRA – those with left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure. There are no controlled clinical data on the safety or efficacy of VIAGRA in the following groups; if prescribed, this should be done with caution. Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; Patients with resting hypotension (BP <90/50 mmHg) or hypertension (BP >170/110 mmHg); Patients with cardiac failure or coronary artery disease causing unstable angina. Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result.
Antiretroviral Agents
VIAGRA should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia). However, there are no controlled clinical data on the safety or efficacy of VIAGRA in patients with sickle cell or related anemias. Physicians should advise patients to stop use of all phosphodiesterase type 5 (PDE5) inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a rare condition and a cause of decreased vision including permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors. Based on published literature, the annual incidence of NAION is 2.5–11.8 cases per 100,000 in males aged ≥ 50. the use of PDE5 inhibitors or to other factors [see Adverse Reactions (6.1, 6.2)].
Renal Dose Adjustments
An observational case-crossover study evaluated the risk of NAION when PDE5 inhibitor use, as a class, occurred immediately before NAION onset (within 5 half-lives), compared to PDE5 inhibitor use in a prior time period. The results suggest an approximate 2-fold increase in the risk of NAION, with a risk estimate of 2.15 (95% CI 1.06, 4.34). A similar study reported a consistent result, with a sildenafil otc risk estimate of 2.27 (95% CI 0.99, 5.20). Other risk factors for NAION, such as the presence of "crowded" optic disc, may have contributed to the occurrence of NAION in these studies. Neither the rare post-marketing reports, nor the association of PDE5 inhibitor use and NAION in the observational studies, substantiate a causal relationship between PDE5 inhibitor use and NAION [see Adverse Reactions (6.2)]. Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers.
| Dosage | Recommended Use | Onset of Action | Duration of Effect | Typical Frequency |
|---|---|---|---|---|
| 10 mg | Mild to moderate ED cases | 30-60 minutes | Up to 4-6 hours | Once per day, as needed |
| 20 mg | Moderate to severe ED | 30-60 minutes | Up to 4-6 hours | Once per day, as needed |
| 5 mg | For elderly or sensitive users | 30-60 minutes | Up to 4 hours | Once per day, as needed |
PDE5 inhibitors, including VIAGRA, and alpha-adrenergic blocking agents
What Other Drugs Interact with Sildenafil?
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What is Sildenafil?
If you’re considering this treatment, expert guidance is essential. Lakeview Pharmacy is here to help—with personalized care, safe prescriptions, and years of experience in men’s health. Contact us today to learn more about how we can support your wellness and provide the solutions you’re looking for. VIAGRA- sildenafil citrate tablet, film coated Pfizer Laboratories Div Pfizer Inc For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, VIAGRA may be taken anywhere from 30 minutes to 4 hours before sexual activity. are both vasodilators with blood pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may occur.
| Parameter | Value | Notes |
|---|---|---|
| Absorption Rate | Rapid | Peak plasma levels in ~60 minutes |
| Bioavailability | Approximately 40% | Due to first-pass metabolism |
| Half-life | About 4 hours | Time to reduce plasma concentration by half |
| Metabolism | Liver (primarily via CYP3A4) | Enzymatic breakdown |
| Excretion | Mainly feces (~80%) | Some via urine (~13%) |
In some patients, concomitant use of these
5.6 Combination with other PDE-5 Inhibitors
Physicians should consider whether their patients with underlying NAION risk factors could be adversely affected by use of PDE5 inhibitors. Individuals who have already experienced NAION are at increased risk of NAION recurrence. Therefore, PDE5 inhibitors, including VIAGRA, should be used with caution in these patients and only when the anticipated benefits outweigh the risks. Individuals with "crowded" optic disc are also considered at greater risk for NAION compared to the general population, however, evidence is insufficient to support screening of prospective users of PDE5 inhibitors, including VIAGRA, for this uncommon condition. There are no controlled clinical data on the safety or efficacy of VIAGRA in patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases); if prescribed, this should be done with caution. two drug classes can lower blood pressure significantly
- Sildenafil 10mg is available by prescription only.
- Do not exceed the recommended dose to prevent adverse effects.
- Alcohol consumption can increase side effects of sildenafil.
- Sildenafil 10mg may interact with certain medications.
- Patients with heart issues should consult a doctor before use.
[see Drug Interactions (7.2) and Clinical Pharmacology (12.2)]
| Brand/Source | Price per Tablet | Package Size | Cost per Pack | Notes |
|---|---|---|---|---|
| Brand A | $3.00 | 30 tablets | $90.00 | Trademarked, pharmacy purchase |
| Generic B | $0.50 | 60 tablets | $30.00 | FDA-approved generic |
| Online Supplier C | $0.20 | 90 tablets | $18.00 | Bulk purchase, check authenticity |
| Local Pharmacy D | $1.00 | 20 tablets | $20.00 | Over-the-counter available |
leading to symptomatic hypotension (e.g., dizziness, lightheadedness, fainting).
5.1 Hypotension
The maximum recommended dosing frequency is once per day. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. VIAGRA was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors such as organic nitrates or organic nitrites in any form is therefore contraindicated [see Contraindications (4.1), Drug Interactions (7.1), and Clinical Pharmacology (12.2)]. When VIAGRA is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at 25 mg [see Warnings and Precautions (5.5), Drug Interactions (7.2), and Clinical Pharmacology (12.2)]. The recommended dose for ritonavir-treated patients is 25 mg prior to sexual activity and the recommended maximum dose is 25 mg within a 48 hour period because concomitant administration increased the blood levels of sildenafil by 11-fold [see Warnings and Precautions (5.6), Drug Interactions (7.4), and Clinical Pharmacology (12.3)].
Serious Side Effects
Consider a starting dose of 25 mg in patients treated with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, or saquinavir) or erythromycin. Clinical data have shown that co-administration with saquinavir or erythromycin increased plasma levels of sildenafil by about 3 fold [see Drug Interactions (7.4) and Clinical Pharmacology (12.3)]. Consider a starting dose of 25 mg in patients > 65 years, patients with hepatic impairment (e.g., cirrhosis), and patients with severe renal impairment (creatinine clearance <30 mL/minute) because administration of VIAGRA in these patients resulted in higher plasma levels of sildenafil [see Use in Specific Populations (8.5, 8.6, 8.7) and Clinical Pharmacology (12.3)]. VIAGRA is supplied as blue, film-coated, rounded-diamond-shaped tablets containing sildenafil citrate equivalent to 25 mg, 50 mg, or 100 mg of sildenafil. Tablets are debossed with PFIZER on one side and VGR25, VGR50 or VGR100 on the other to indicate the dosage strengths.